Cancer and Pregnancy
Pregnancy is a happy time for most
women. Occasionally, however, serious problems can occur. Cancer in
pregnancy is one serious complication that occurs rarely.
This discussion is included not to scare
you but to provide you with information. It is not a pleasant subject
to discuss, especially at this time. However, every woman should have
this information available.
• to inform you of a serious problem that can occur during pregnancy
• to provide you with a resource to
help you form questions for a dialogue with your healthcare provider,
if you wish to discuss it
If you’re now pregnant and you have had
cancer in the past, tell your healthcare provider as soon as you find
out you’re pregnant. He or she may need to make decisions about individualized care for you during pregnancy.
Cancer during Pregnancy.
Tremendous changes affect your body during pregnancy. Some researchers
believe cancers influenced by increased hormones may increase in
frequency during pregnancy. Increased blood flow may increase cancer to
other parts of the body. Body changes during pregnancy can make it
difficult to find or to diagnose an early cancer.
When cancer occurs during pregnancy, it
can be very stressful. The healthcare provider must consider how to
treat the cancer, but he or she is also concerned about the developing
baby.
How these issues are handled depends on when cancer is discovered. A woman’s concerns may include the following.
• Will the pregnancy have to be terminated so the cancer can be treated?
• Will treatment or medications harm the baby?
• Will the malignancy affect the baby or be passed to the baby?
• Should therapy be delayed until after delivery or after termination of the pregnancy?
Cancer during pregnancy is a rare
occurrence; it must be treated on an individual basis. Some cancers
found during pregnancy include breast tumors, leukemia, lymphomas,
melanomas, bone tumors and cancer of female organs, such as the cervix,
uterus and ovaries.
Anticancer drugs stop cell division to
help fight the cancer. If taken during the first part of pregnancy,
they can affect cell division of the embryo.
Breast Cancer.
Breast cancer is uncommon in women younger than 35. Fortunately, it’s a
rare complication of pregnancy. However, breast cancer is the most
common type of cancer diagnosed during pregnancy. Of all women who have
breast cancer, about 2% are pregnant at the time of diagnosis.
During pregnancy, it may be harder to
discover breast cancer because of changes in the breasts. Most evidence
indicates pregnancy does not increase the rate of growth or spread of a breast cancer.
Studies indicate
pregnancy is safe in women with a history of breast cancer if the
cancer has been successfully treated. Treatment of breast cancer during
pregnancy varies. It may require surgery, chemotherapy and/or
radiation. Recent studies indicate chemotherapy for breast cancer
during pregnancy may be safe.
A form of breast cancer you should be aware of is inflammatory breast cancer
(IBC). Although rare, it can occur during and after pregnancy, and may
be mistaken for mastitis, which is inflammation of the breast. Symptoms
of inflammatory breast cancer include swelling or pain in the breast,
redness, nipple discharge and/or swollen lymph nodes above the
collarbone or under the arm. You may feel a lump, although one is not
always present.
If you experience any of these symptoms, do not panic!
Nearly all of the time it will be a breast infection related to
breastfeeding. However, if you’re concerned, contact your healthcare
provider. A biopsy is used to diagnose the problem. To learn more about
IBC, visit www.ibcsupport.org.
Other Cancers.
Cervical cancer is believed to occur about once in every 10,000
pregnancies. However, about 1% of the women who have cancer of the
cervix are pregnant when it’s diagnosed. Cancer of the cervix is
curable, particularly when found and treated in its early stages.
Malignancies of the vulva, the tissue
surrounding the vaginal opening, have also been reported during
pregnancy. It is a rare complication.
Hodgkin’s disease (a form of
cancer) commonly affects young people. It is now being controlled for
long periods with radiation and chemotherapy. The disease occurs in
about 1 of every 6000 pregnancies. Pregnancy does not appear to have a
negative effect on the course of Hodgkin’s disease.
Pregnant women who have leukemia
have demonstrated an increased chance of premature labor or increased
bleeding after pregnancy. Leukemia is usually treated with chemotherapy
or radiation therapy.
Melanoma is a cancer derived from skin cells that produce melanin (pigment). A malignant melanoma can spread through the body. Pregnancy may cause symptoms or problems to worsen. A melanoma can spread to the placenta and baby.
Bone tumors are rare during pregnancy. However, two types of noncancerous bone tumors can affect pregnancy and delivery. These tumors, endochondromas and benign exostosis,
can involve the pelvis; tumors may interfere with labor. The
possibility of having a Cesarean delivery is more likely with these
tumors.
It may be harder to lose your pregnancy
weight after having twins, so stick to the weight goal your healthcare
provider gives you. In addition, carrying two babies causes more
changes in your body, which may cause you to hold onto the weight you
gain during pregnancy.
7. Exercise for Week 32
One exercise you can do during pregnancy
may help during labor. Using your diaphragm to breathe is beneficial to
you. These are the muscles you will use during labor and delivery.
Breath training decreases the amount of energy you need to breathe, and
it improves the function of your respiratory muscles. Practice the
different breathing exercises below for benefits in the near future
(labor and delivery!).
• Breathe in through your nose,
and exhale through pursed lips. Making a little whistling sound is OK.
Breathe in for 4 seconds, and breathe out for 6 seconds.
• Lie back, propped on some
pillows, in a comfortable position. Place your hand on your tummy while
breathing. If you breathe using your diaphragm muscles, your hand will
move up when you inhale and down when you exhale. If it doesn’t, try
using different muscles until you can do it correctly.
• Bend forward to
breathe. If you bend slightly forward, you’ll find it’s easier to
breathe. If you feel pressure as your baby gets bigger, try this
technique. It may offer some relief.